Medicaid cases rise more than 100 percent in past decade

The number of active Medicaid cases in Davidson County has climbed by more than 100 percent in the last decade, according to county and state records.

BY NASH DUNNThe Dispatch

The number of active Medicaid cases in Davidson County has climbed by more than 100 percent in the last decade, according to county and state records.There are nearly 16,000 active family and children Medicaid cases in the county, compared to a little less than 7,500 in 2002. The number of adult Medicaid cases has also increased by about 75 percent in the past 10 years.There are about 27,683 Medicaid eligibles in Davidson County, or about 17 percent of the county's population, according to the North Carolina Division of Medical Assistance and the U.S. Census Bureau.Dale Moorefield, director of the Davidson County Department of Social Services, say the statistics are almost all linked to the economy."People in Davidson County have been hit hard by the economic troubles our nation has had," Moorefield said. "Especially in Davidson County, we were hit hard a little bit earlier because of the furniture industry, and a lot of those jobs going out of the country and overseas in the 2000s."There are close to 2 million Medicaid eligibles across the state, and the program served more than 1.7 million citizens in Fiscal Year 2010-11, according to the N.C. Division of Medical Assistance.The state has averaged more than $10 billion in total claims expenditures in recent years, with funding for the Medicaid program coming about two-thirds from federal dollars and one-third from state appropriations.The Davidson County DSS has been forced to add staff over the last decade to deal with the upward trend. DSS has added 10 staff members to handle case loads for family and children's programs, said Joyce Roach, program administrator for income maintenance."I think we've done a good job," Roach said, adding that the county benefits from having caseworkers equipped to handle enrollees in both the Medicaid and food and nutrition programs. Davidson County is one of the only counties in North Carolina to have staff trained in handling citizens needing both services."As both of those programs have increased, it is a strain on staff to be able to try to keep up with that," Moorefield said, adding that qualifications for the food and nutrition programs have become less stringent over the years while Medicaid requirements have remained mostly the same. "That makes it a little more flexible for staff. "It also makes it so when the client comes into our office, they don't see two individuals for two different benefits. They see the same person that doesn't have to share that information with someone else. They have one worker, which is less confusing for them, and I think is more efficient for the agency."DSS has also used an electronic document management system to deal with the influx of enrollees in the county. Moorefield said the technology allows the department to be paperless and more efficient."It's more cost effective for us to do that than hire additional staff, with additional salary and benefits," Moorefield said. "We have had to add some staff, but we haven't added the staff we've needed to do the programs, because we try to maximize the resources and do them the best we can. We try to be as lean as we can be, and using that technology has allowed us to be as lean as we can with staff that do the programs."Larry Potts, vice chairman of the Davidson County Board of Commissioners and chairman of the Davidson County Department of Social Services Board, said the numbers of active and eligible Medicaid cases is staggering."I think due to the economy and downturn in people's incomes, in addition to working one or two jobs, it made more people eligible, particularly children," Potts said. "The government has an enormous responsibility there, and I don't see how it can be maintained forever."Nash Dunn can be reached at 249-3981, ext. 227, or at nash.dunn@the-dispatch.com.

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